Healthcare Provider Details

I. General information

NPI: 1598862872
Provider Name (Legal Business Name): HUGH HETHERINGTON, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 HIGHLAND BLVD SUITE 1160
BOZEMAN MT
59715-6900
US

IV. Provider business mailing address

925 HIGHLAND BLVD SUITE 1160
BOZEMAN MT
59715-6900
US

V. Phone/Fax

Practice location:
  • Phone: 406-587-5000
  • Fax: 406-587-5068
Mailing address:
  • Phone: 406-587-5000
  • Fax: 406-587-5068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number10377
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number6361
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberMT CERTIFICATE # U97
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number227
License Number StateMT
# 5
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number#332HAD
License Number StateMT

VIII. Authorized Official

Name: DR. HUGH ELLIOTT HETHERINGTON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 406-587-5000